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Maximum hypothermic ischemia in replants containing muscular tissue.

W A van Alphen¹, A R Smith, F J ten Kate

¹Department of Surgery, University Hospital Rotterdam, Dijkzigt, The Netherlands.

The Journal of Hand Surgery

|May 1, 1988

Summary

Investigating latissimus dorsi muscle viability after hypothermic ischemia in rabbits revealed increasing tissue damage with longer ischemia times. Necrosis was observed after 24 hours, with degenerative changes evident earlier.

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Area of Science:

Muscle physiology
Surgical research
Tissue regeneration

Background:

Replantation surgery requires understanding tissue tolerance to ischemia.
The latissimus dorsi muscle is crucial for reconstructive procedures.
Hypothermic storage is used to extend tissue viability during ischemia.

Purpose of the Study:

To evaluate the histological effects of varying hypothermic ischemia durations on rabbit latissimus dorsi muscle.
To determine the threshold for irreversible muscle damage and necrosis.

Main Methods:

Rabbit latissimus dorsi muscles underwent excision and replantation after 5, 8, 16, or 24 hours of hypothermic (5°C) ischemia.
Muscle sections were microscopically analyzed for degenerative changes and necrosis.

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Fibroblast proliferation was also assessed.

Main Results:

Complete or near-complete necrosis was observed in all 24-hour ischemia groups.
Slight to severe degenerative changes and significant fibroblast proliferation were noted in 5-, 8-, and 16-hour groups.
A trend showed increased degenerative changes with longer ischemia durations, though not statistically significant.

Conclusions:

Prolonged hypothermic ischemia significantly impacts latissimus dorsi muscle viability.
Early degenerative changes occur within hours, progressing to necrosis with extended ischemia.
These findings are critical for optimizing preservation times in muscle replantation surgeries.